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. <br /> (TnPHFR nNL ('__�I.I- <br /> F.�.Y: 651-354-0170 <br /> PHOiVE: 651--�54-0002 <br /> FAX-a-LOCaTE REOUEST FORIVI <br /> Caller ID Number 212 Fax number 952-446-1836 <br /> Company name Widmer Inc. <br /> �'� Phone number 952-446-1495 <br /> Caller name�-�y <br /> Ex losives � No R.O.W. (Y/I� Yes Duration of job �C(�s <br /> P �' <br /> Type of�vork s�`�``- ��-'%al��� /�c/ <br /> Work being done for /1'%�.�� ����'� C'�a " ��� � ���� <br /> County /l`,�,� City/Place �oti� � - <br /> Address ,�� � Street �s� � ��� - <br /> Nearest cross street C��-SCJ ��'� - <br /> Location of�vork /���5 � � ���G �� �"`J� - <br /> Remarks /y1%'��/ ��/i 2 � �/ — <br /> Township Range Section/Quarter <br /> Township Range Section/Quarter <br /> OR <br /> Cj�_ . �- � <br /> Hudson Page and Grid � <br /> For Gopher State One-Call use only <br /> Ticket number ��> > y�� � Work to begin date <br /> Utilities Notified ��- ��� l��� ����J <br />